High blood pressure and heart palps

[Meggy79]

Hi. I had a TT for toxic nodules a year ago.  Since then I have been on Synthroid by itself then with Cytomel, Tirosint by itself then with Cytomel , Nature-Throid and now compounded t4 and compounded sustained release t3. I cannot get rid of the heart palps and high blood pressure. I feel terrible.  My latest labs 2 weeks ago were

Tsh 0.06  0.34-5.60
Ft4 0.77  0.76-1.46
Ft3 2.49 218-3.98
rt3 21.2. Ratio -11.74

I know my rt3 is bad but don't know what to do about it
At the time of the test I was taking 1 grain of Nature-Throid split in half .If I tried to go above that amount the palps and BP  went even higher.   Now I am on 20 mcg of compounded t4 and 2 mcg of compounded sustained release t3.  I have been to an endrocrinologist  (more diabetic than thyroid) and now a natural MD. No one seems to have an answer.  I do not want to take 2 BP medicines because of a thyroid problem. I did not have any heart problems before all of this thyroid started.  Does anyone have any ideas or help for me?  Also, I am very sensitive to medicine .  I would stop everything if I could.  Please help. I am ready to give up

[Meggy79]

gimel, thank you so much.  You have given me hope.  Yes, I am able to get tested quickly.  My dr is very good about ordering tests. Thank you again!!

[gimel]

your Free T4 and Free T3 levels are much too low, and consistent with being hypothyroid, with accompanying symptoms.  Even the palps/high BP are possibly hypothyroid symptoms.  From a very long list of symptoms that can be hypothyroid related, this is the section that is heart related.

Heart:

    High blood pressure
    Low blood pressure
    Slow/weak pulse (under 60 bpm)
    Fast pulse (over 90 bpm at rest)
    Arrhythmia (irregular heartbeat)
    Skipped beats
    Heart flutters
    Heart palpitations
    Chest pain
    High cholesterol
    High triglycerides
    High LDL (“bad”) cholesterol
    Mitral Valve Prolapse
    Atherosclerosis
    Coronary Artery Disease
    Elevated C-Reactive Protein
    Fibrillations
    Plaque buildup
    Fluid retention
    Poor circulation
    Enlarged heart
    Congestive Heart Failure
    Stroke
    Heart Attack



Your Reverse T3 level is high and the ratio of Free T3 to RT3 is too low, as you mentioned.  Even if your Free T3 were raised to the top of the range, the ratio would still be borderline, according to some sources.  So apparently you need to both raise your Free T4 and Free T3 with thyroid med, and reduce your RT3.  It might be better to not add more T4 med until you find out the potential cause for the high RT3 level.  

Among the possible causes for high RT3 is high cortisol, leptin resistance, inflammation (NF kappa-B), dieting, nutrient difficiencies such as low iron, selenium, zinc, chromium, Vit B6 and B12, Vit D and iodine, Low testosterone, low human growth hormone, Insulin dependent Diabetes, Pain, Stress, environmental toxins, Free radical load, Hemorrhagic shock, Liver disease, Kidney disease, Severe or systemic illness, severe injury, Surgery, Toxic metal exposure..   In other words a daunting task.  

I think the best approach would be to start by testing for ferritin (iron), selenium, zinc, Vitamin B6 and B12 and Vitamin D.  I say that because hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Also, hypo patients low in ferritn can have reactions to raising thryoid med dosages.  Any of these that show low can be supplemented to bring them to optimal.  Palps can also sometimes be associated with low potassium and magnesium, so it would be good to verify those are okay also.

With your reaction, I would hold off on any med increases other than maybe trying a small increase in T3, until you are able to get those tests done so you can see what is going on and take whatever action is needed.  Do you think you could get those tests done soon?